Abstract

BARREIRO, Pedro; CHAGAS, Cristina; COUTO, Gilberto  and  MATOS, Leopoldo. Toxic megacolon as first manifestation of severe ulcerative colitis: A clinical challenge. J Port Gastrenterol. [online]. 2012, vol.19, n.5, pp.251-254. ISSN 0872-8178.

Exacerbations of ulcerative colitis can lead to a wide spectrum of clinical manifestations from mild severity, sub-clinical, to fulminant colitis or toxic megacolon, which can threat the life of the patient. In the latter, the response to steroids is usually effective, yet about 30% of patients fail to respond, being steroids refractory. Here, we present the case of a 45 years old woman who developed a toxic megacolon as a first manifestation of a steroid refractory ulcerative colitis. The early use of medical therapy with infliximab resulted in an excellent clinical and endoscopic response. We briefly review the clinical approach to severe ulcerative colitis and steroid-refractory.

Keywords : Steroid refractory ulcerative colitis; Toxic megacolon; Infliximab.

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